Young girls who receive the vaccine Gardasil for human papillomavirus are no more prone to become pregnant or infected by sexually transmitted diseases than girls who do not receive the vaccine, according to a study in the journal Pediatrics.

“We present the first evaluation of sexual activity-related outcomes after adolescent HPV vaccination in the recommended age range of 11–12 years to use clinical outcomes and show that receipt of HPV vaccine is not associated with an increased rate of sexual activity-related outcomes,” says the study “Sexual Activity-Related Outcomes After Human Papillomavirus Vaccination of 11 to 12-Year-Olds” (http://pediatrics.aappublications.org/content/early/2012/10/10/peds.2012-1516.full.pdf+html?sid=3a05a0e8-6726-4742-b5b6-fb0c6dcfa48d).

Researchers followed 1,398 girls ages 11–12 who were Kaiser Permanente members in Georgia in 2006 and 2007. The group was divided, with 493 getting at least one dose of Gardasil during the time they were tracked and 905 not getting the vaccine.

“This study provides a clinical validation and extends our understanding of numerous surveys reporting that most young women did not plan to modify their sexual behaviors after HPV vaccination.... If HPV vaccination [were] ‘a license for sex,’ we would [have seen] more adverse outcomes shortly after vaccination, when the girls were more aware of their vaccination status.”

As Managed Care reported in September, only about 35 percent of girls get the full three doses of the vaccine for HPV, pointing to a troubling public health dilemma (/archives/2012/9/hpv-vaccine-goes-underused).

“The HPV vaccine is an achievement we should celebrate,” Gregory D. Zimet, PhD, an HPV researcher and professor of pediatrics at Indiana University School of Medicine, told us. “There should be parades. To have a vaccine that can actually prevent substantial numbers of cancers is an amazing achievement.”

Robert Davis, MD, MPH, a senior investigator at the Kaiser Permanente Center for Health Research – Southeast and a co-author of the Pediatrics study, says that it “adds to the growing evidence that the HPV vaccine is a safe and effective way to prevent these rare but sometimes deadly cancers.”

Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.